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Last week The Telegraph published an article on Shutting out a world of digital distraction which looked at how the internet is affecting the writing of works of literature. Its content is relevant to anyone who uses the internet.

This article peaked my interest in how I deal, or don’t deal with being always connected to the internet via my phone and what that is doing to my productivity and quality of life.

I thought I would share six mechanisms I use to try and pull myself away from the screens once in a while:

Prioritise the hour before going to bed. This let’s my brain stop whirring.

Occasionally leave my phone at home when I go out on a weekend day.

Set certain tasks to complete online in the next 30mins/hour/two hours.

Sign out of my email account and Tweetdeck account when working on documents.

Reminding myself the quality of my work may go up if I wait a little longer to respond to contacts.

Listen to my girlfriend when she’s says, “Get off that damn laptop!”

Figure 1: Information is Beautiful’s clever graphic. I imagine the differing levels of distraction exist for all of us, each personalised to our favourite internet fixes.

Despite these mechanisms the below paragraph struck home far too much for me to be able to say I’m free of the distraction of the internet:

“[Neuroscientist Baroness Susan Greenfield, professor of pharmacology at Oxford University] We all like being acknowledged. Emails and messages reinforce that you’re worth contacting.” The little dopamine hit your body releases every time an email arrives in your inbox or someone tweets at you overwhelms the less immediately gratifying pleasure to be found in long, unbroken periods of thought and introspection, and we become hooked on distractions.

I’ve some way to go to say I’m more in control of my often habitual internet usage.

As a start towards being more in control I’m going to designate Thursday evening as internet free and see how I get on. Perhaps I’ll start on the pile of literature I’ve yet to make it through from Christmas!

In short this guidance looks at whether or not nurses should be using their own phones while at work. The answer from the RCN is no, something I wholeheartedly agree with. Why should an employee have to meet the costs of a job they are employed to do and potentially divulge a personal mobile number in the process?

A look at some of the details

It may be a little picky but I’m disappointed not to see ‘and opportunities’ include in this sentence from the very first paragraph of the guidance:

“…as with the introduction of any technological innovation, new issues [and opportunities] have been raised by mobile phone use in health and social care.”

That aside I was very pleased to read throughout the guidance a tone of understanding about the potential benefit to staff and patient a mobile phone can bring.

Opportunities

Making up for the earlier omission of opportunities the RCN do include a useful list on page three of the benefits of mobile phones. A couple additions I would have added would be continuous professional development and communities of interest but overall it’s a good list and I’ve replicated it below:

The benfits of a mobile phone to staff and patients in health and social care

communication via telephone, SMS text

messaging and email

photography, for example, of patients’ wounds or skin condition

basic tools such as calculator and stopwatch

internet/intranet usage to access guidelines and other knowledge sources

downloadable apps designed for specific purposes

use of global positioning system (GPS) software for getting directions or calculating mileage, and for protection purposes by tracking the location of lone working nursing staff.

[Continuous professional development via access to online and app-based courses]

[Joining communities of interest to share knowledge and solve problems]

A comment on publishing timelines

The report was published on 22 August 2012, yet there are only two references from after 2010, both 2011 RCN reports. There are no references from 2012. In fact the large majority of the online references were accessed on 21 March 2011, nearly 18 months before publishing the report.

In the field of mobile technology 18 months is a long time.

The guidance is flagged for review in July 2014. I would have preferred to see July 2013 for this area of guidance.

Perhaps the RCN guidance needs to be even more dynamic and be reviewed every quarter to keep up with mobile technology? Is there someone within the RCN who would be willing and funded to keep abreast of the subject area all year round?

Conclusion

Overall, I think this is a measured and open minded piece of guidance and well worth a read for an insight into community nurses’ work.

I fear though that nurses on the ground will face a tough road to getting a work phone that is useable, secure and technically able to take full advantage of what an internet enabled phone offers.

As usual local autonomy on policies covering this area in place of a national top-down policy brings its own difficulties.

“I honestly don’t think it matters whether that [NHS care] care is delivered in a state hospital or a privately operated GP surgery.”

I highlight it not because it is a very insightful article but because this is the first time I have seen a GP surgery being classed as private by a politician.

To often for my liking GPs are seen as the guardians of the NHS despite being private contractors. They are not part of the NHS but an extremely key partner, just like the private sector already is through contracts to help the NHS get through its elective waiting lists.

Politicians would do well to help the public understand that GPs don’t necessarily always hold the NHS’ best interests at heart. After all they too are running a business, a business that has to make a profit.

Why we need a national framework for patient experience

This framework is designed to ‘to apply a single generic framework for patient experience to a wide range of health conditions and settings’. Jocelyn sets out well the challenges that stand in the way of getting the framework adopted across the NHS.

One she doesn’t explore fully is the engagement staff who may well own patient experience questionnaires as part of their work. In my experience NHS engagement professionals are often extremely wary of change preferring to stay within the comfortable boundaries of face-to-face meetings (during work hours) or presentations in town halls to audiences of older people and the usual community champion suspects.

Implementing the framework without a top-down dictat will require a huge amount of engagement work with NHS engagement professionals to teach them that their local population isn’t that different from others and that the same questions across the nation apply to them too. After all a knee op is a knee op in Newcastle or Bristol.

The framework is a great step towards pushing patient experience up the agenda and I hope comms and engagement staff across the NHS embrace it and become experts in it alongside their clinical colleagues.

Ruth Carnall give us her views on Health and Wellbeing Boards in London

While the context may not be of interest to many (even though HWBs offer a lot to think about and act upon, especially integrated care) the point of me showing you this is to break down how easy it is:

Film Ruth answering 3-4 questions with a Flipcam

Download the films to my laptop

Use basic Windows Movie Maker to cut them together

Insert a couple of fade outs and fade ins

Publish (wait a while as your processor works hard)

Upload to YouTube

Promote: Tweet, embed and share with staff and colleagues.

Total time taken to get all this done? About 2 hours. Easy!

Hint: Make sure the interviewer asks the interviewee to repeat the question in their answer and tell the interviewee not to jump straight in after the answer has finished so editing is made easier.

NB: Windows Movie Maker is included on most, if not all, Windows laptop and desktop packages, but is nowehere near as good as Final Cut or Final Cut Pro on a Mac

National Citizen Service (NCS)

This government initiative is an opportunity for 16 year olds to explore their skills, likes and dislikes through outdoor pursuits, helping their communities and creative endeavours such as making short films.

A lot of thinking is currently going into how to make the most of the talent, energy and enthusiasm that British youth have and I like the sound of NCS as part of the answer.

It doesn’t prescribe a right and wrong Q&A style education like exams, it enables participants to learn through making mistakes (e.g. do taking the right gear when hiking) and gives them the freedom to be creative and explore what makes them tick, something the school system doesn’t do very often. Additionally, as the programme looks to add value to their CV, helping them show the breadth of experience required these days on job and university applications.

Covering the categories of photography, illustration, informational posters and graphics, interactive games and videos the competition winners just goes to show how important visualising science and not just writing about it is. The pictures even got a raise of interest from a few non-science colleagues.

Also, it’s great to see that software is helping make science more interactive and ‘real’ to an audience of non-scientists and enthusiasts.

One for the reading list this but it sneaks into the read round-up as I’ve read the first few pages with great interest.

As I understand it an asset approach is effectively a look at how partnerships between individuals, public sector organisation and private sector organisations can look for the existing positives in communities and seek to maximise them in time and space (positive things happening more often over wider areas).

As the publications says: ‘The asset approach values the capacity, skills, knowledge, connections and potential in a community. It doesn’t only see the problems that need fixing and the gaps that need filling. In an asset approach, the glass is half-full rather than half empty.’

On first look the asset based approach looks to complement the growth of thinking around complexity and how people and organisations interact with each other. So I reckon it is worth a read and a mull over.

Mark Spencer has stuck his head over a political and clinical parapet no politician has publicly dared to yet, full marks to him.

The is limited, if not no understanding in the wider English public of how the NHS works and how it could work better in the future.

The NHS must reform, now (that does not say I agree or disagree with the current plans) and it is key that the public are spoken to and with by people in positions of knowledge so that the public can make an informed democratic decision.

The General Medical Council takes on social media

It is great to see often seen as an inward facing and conservative organisation approaching social media openly especially as they have been brave enough to give a relative newbie the chance to educate his peers. It is also good to see the leaders of tomorrow at the GMC are engaged with social media, its positives, negatives and potential.

On an aside this serves as another example that social media and digital communications offers a great way for young people to get noticed and present themselves as ones to watch for the future.

I’m also glad to see that medical and non-medical education is mentioned and seen to be key to the wider NHS picking up social media more widely and with less apprehension.

However, all that said the tone of some of the article is a shame:

“Inappropriate use of social media can raise questions about your suitability to become a doctor, which could result in your medical school launching a fitness to practise investigation into your conduct. Your medical school is not allowed to let you graduate if you are not fit to practise. This is a last resort and would only happen in the most serious of cases.”

While a very important part of considering social media’s role in healthcare why did the article need to concentrate so much on this aspect? Why not accentuate the positives from Craig’s experiences. I smell an older colleagues hand in the editor chair here.

Overall a great step in the right direction. Perhaps the next article could be from an older doctor who uses social media and direct people to where they can learn about the positives of social media in healthcare.

One thing which stands out for me is the driver behind the adopters of social media – many of them pick up social media to engage with a wider community to garner better ideas and promote idea sharing. So there are some good examples in there which I think could be useful to share with colleagues and promote the use of social media.

This is an interesting article on the BBC website on depression and resilience to it. It’s a good piece of science communication I think, talking about the people and their lives before the science words flow.

I find mental health and specifically the treatments for common conditions interesting and it’s good to see the R&D side get some coverage. With the recession and winter biting at our heels it is nice to know researchers in Manchester are looking at how we can do better when depression comes a-calling.

If you’re looking for somewhere you can learn a little more about the things you can do on a daily basis to help prevent depression have a look at Moodscope – a good mood trend analysis tool and source of hints and tips.

This article got LOADS* of comments. Too many to go over them all so do go and have a look.

In the meantime can anyone tell me whether email secure? Is a closed secure network the only way to go?

Another query I have is can email to clinical staff work in isolated local areas (like those told of in the article) or does there need to be a national standard in place?

Finally, how much damage has the utter failure (only in a pr sense, if not totally) of the National Programme for IT done to the future of NHS IT use including emails, telecare and online engagement & consultation tools? I fear quite a lot.

*LOADS = 98 at last look

Report highlights benefits of genomic innovation

I love a bit (a lot) of science in my life. I listen to Radio 4 science podcasts every week as I commute into work and one area which has always interested and excited me is genomics, that’s the study and application of knowledge about the whole genome of an organism. The power this relatively new field is giving us in understanding and fighting disease is immense.

What worries me often is that advances in the lab aren’t being taken advantage of at the bedside or within primary care. Genomics can help us tell which drug and at what dose patients will respond to best and help in clinical decision making when treating major diseases such as cancer. While costs of such tests are decreasing I get the feeling clinicians knowledge of their existence and potential use isn’t increasing (I have no evidence of this).

That is why I spent my Thursday evening reading the DH commissioned report into the use of genomics in the NHS. Placing the responsibility of nurturing this field for the NHS at the National Commissioning Boards door the 83 pages set out how the NHS can take best advantage of this nascent field and help the UK economy at the same time.

My highlights from the report are:

The clear steer that collaboration between multiple organisations from the public and private sector and not an overbearing behemoth is what is needed to make the most of advances.

An acute understanding that clinical training in genomics is absolutely key, not only for tomorrow’s experts but across the board so overall knowledge increases. After all patients can get a lot of their understanding from healthcare staff.

The multiple and repetitious statement that the public must be brought with the health and bioscience sectors in understanding and taking up these technologies – see Chapter 9 of the report.

As the report states it is difficult to measure the web economy but I welcome any attempt to put a financial figure on all this ‘soft’ social media stuff, even if at present that is a weak casual link between a growth in use of social media and a growth in the web economy.

Interestingly within the BBC article there is also this snippet:

“Technology giant IBM estimates that by 2015, one trillion devices will be internet-connected”

That is pretty amazing! An interconnected web of things all talking to each other, monitoring themselves and auto adjusting. Imagine heating systems checking the weather and setting the temperature for your home based on the best balance between economic, comfort and green factors, your phone being a hub from which you can control your TV and cooker and check on the status of your front door lock. No more running home to check you turned the iron off or closed the windows!

The article also eludes to the growing internet ecosystems like Facebook and Amazon. Perhaps one day we’ll have an NHS internet ecosystem in which you can sort appointments, see your medical records and compare services. Maybe.

A nice little post from the 21st December 2011 on healthworkscollective.com describing how groups of Paediatricians across New York State (53,000 sq miles in area, over 300 miles from north to south) have started using Google+ Hangout to enable them to have bigger and better meetings. Taking the focus away from just those Paediatricians in Manhattan and giving those across the state a chance to share ideas and knowledge. The post includes a top 5 tips for using Google+ Hangout.

Do any UK clinicians use this at the moment? Do you think it could be a valuable addition to your Continuous Professional Development training and networking?
As a non-clinician I certainly think a Google+ hangout with a few of my peers would be useful, but only if there was a good chair and a solid agenda.

‘Spam volume dropped from more than 379 billion messages daily to about 124 billion messages daily between August 2010 and November 2011—levels not seen since 2007 —as law enforcement and security agencies shut down major spam-sending botnets, according to Cisco. In September 2011, India was generating the highest percentage of spam volume (13.9%). Vietnam was second with 8% and the Russian Federation was third with 7.8%.’Source: Cisco Connected World Technology Report

Spam is not an area of computing I understand at all but the numbers in the above are incredible, almost fantastical, so I thought I’d share nonetheless.

Lucifer’s Boob
A 32 year-old friend of a colleague was recently diagnosed with breast cancer and has decided to write a blog about her experiences. Whilst the subject matter is fairly grim she manages to make the blog funny and it’s full of pathos without being overly emotional. She is also very honest about the NHS and has pretty much nothing but praise for all concerned.
Give it a look and I hope it helps to show the power of the written (digital word).http://lucifersboob.blogspot.com/
P.s. Read it from the bottom, as it’s in chronological order.

Stand outs for me are:
• Parents of 10 year olds (Facebook don’t allow children under 13 to sign up) are signing their children up for them
• 55% of active Twitter users access the service from their mobile (it’d be interesting to know if they also use desktop and laptops and which is most popular by minutes spent on Twitter/Tweetdeck/Other management software/webpage)
• 56% of college students said that if they were offered a job by a company that banned social media use, they’d turn it down  how is the NHS going to ensure that it gets and retains the top digital talent needed to provide world class digital healthcare services and informations?

I hope you enjoyed the first ATT read-round-up of 2012. I hope to get a few more published over the coming months. Happy New Year to you all let 2012 be a happy one!